Patients Want Access to More Health Plan Information; Yet Few States Address Plan Transparency

More than 1/3 of patients have difficulty accessing plan information when shopping for coverage

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Mar 20, 2015, 09:30 ET

WASHINGTON, March 20, 2015 /PRNewswire-USNewswire/ -- A new survey sponsored by the National Health Council (NHC) and conducted by Lake Research Partners, one of the nation's top public opinion research firms, finds that patients shopping on exchanges often have difficulty accessing the information they need to make an informed decision about their insurance. Specifically, the survey found that more than one-third of exchange consumers with chronic conditions had a hard time finding information about covered providers and medications. Yet, of state exchanges analyzed by the NHC, only seven have additional website resources and tools beyond the federal minimum requirements, and only one state has passed contracting requirements to enhance plan information transparency.

The national survey found many patients with chronic conditions did not find critical plan features easy to access on exchange websites:

36% of respondents said a list of participating providers was hard or very hard to find
38% said a list of prescription drugs was hard or very hard to find

"The study finds that patients want to pick a plan that meets their needs. But we need to ensure exchanges provide them the tools to make it possible," said Marc Boutin, NHC Chief Executive Officer. "In particular, transparency standards and easy-to-use decision support can help patients make an informed decision about their insurance."

The research found that an overwhelming majority of patients would find added consumer support helpful when choosing coverage. Only 37% of patients enrolled in silver plans reported they had all the information they needed when making a decision. When presented with a list of possible web-based tools,

88% of all respondents said having a standardized list of covered providers would be helpful when selecting a plan;
85% said a standardized list of covered drugs, and
83% said a calculator to help them estimate their out-of-pocket health costs.

While federal rules set minimum requirements for the exchanges, some states have taken extra steps to make their insurance markets more patient focused. With the assistance of Avalere Health, the NHC evaluated 32 states on 15 metrics identified as important to the patient community and spread across 5 principles – non-discrimination, transparency, state oversight, uniformity, and continuity of care. All states analyzed have taken steps to enhance the patient experience, but to widely varying degrees. Twenty out of the 32 states have addressed five or fewer of the metrics as of January 1, 2015.

Founded in 1920, the National Health Council (NHC) is the only organization that brings together all segments of the health community to provide a united and effective voice for the more than 133 million people living with chronic diseases and disabilities and their family caregivers. Made up of more than 100 national health-related organizations and businesses, its core membership includes the nation's leading patient advocacy organizations, which control its governance. Other members include professional and membership associations, nonprofit organizations with an interest in health, and major health insurance, pharmaceutical, medical device, and biotechnology companies.

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